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Frequently asked questions about the Healthwatch Devon service

We would never expect to engage with all 800,000 people in Devon because the vast majority make little use of health and care services, and are unlikely to have much feedback to offer. For example, in the case of Devon’s hospitals:

• Around 1% of the population attends hospital as outpatients
• Around 0.3% of the population attends hospital Accident and Emergency departments
• Around 0.15% of the population attends hospital through elective admission

(Source: Devon Joint Strategic Needs Assessment 2012, Hospital Activity)

On top of this, there is the fact that most people attending hospital have a perfectly good experience, and no need to offer feedback.

The same is true for other health and care services as well, so to get hundreds (rather than thousands) of responses to our surveys is exactly what we would expect.

Healthwatch Devon is not a political organisation.  We do not get involved in campaigns, and do not take sides in arguments over things like privatisation and funding.  Our job is to work with all providers of health and care services – whether public, private or charitable.

Our focus is always the patient or service user, and their experience of the service they receive.  If the patient experience is good, we will highlight and share the good practice, no matter which sector it comes from.  Likewise, if the patient experience is bad, we will say so – whoever the provider is.

Care homes in Devon are inspected by the Care Quality Commission, which publishes reports of its findings, and takes action against poor standards.

Healthwatch Devon does not seek to duplicate the work of the CQC. But if we hear about concerns with standards in a care home, we pass those concerns on to the CQC, to help guide their inspections. Please remember that we also want to hear about good experiences of care home residents as well, so that we can share the good practice.

The information goes to senior managers in the health and care system, to help them understand what works – and what doesn’t – from the point of view of service users. To see how we work in practice, see our Every Comment Counts poster, or have a look at the Your Feedback pages.

Managers of health and care services do take notice of the information we pass on to them. Here are a couple of comments:

“We were delighted to receive such a comprehensive report from patients, carers and the public regarding non-urgent care in Devon. Understanding the patient experience is essential in the delivery of high quality care.”
Patient Experience Manager, NHS England – Devon, Cornwall & Isles of Scilly Area Team

“We would like to thank Healthwatch Devon for the work carried out in compiling this feedback. We are delighted that there were over 500 responses to the survey …This report has provided a wealth of useful information which can be used in many of the CCG work streams.”
NEW Devon Clinical Commissioning Group (CCG) Formal Response to Non-Urgent Care Survey Report by Healthwatch Devon.

Managers of health and care services have to look at many different things when they are thinking about how to improve services. These include:

• Money – and the need to work within budgets
• Staffing – whether there are sufficient properly trained staff available
• Clinical outcomes – how any changes to a service affect the medical treatment and wellbeing of patients
• Premises – what buildings are available for the location of a service, and whether they are physically suitable

Feedback from patients and service users has to be looked at alongside all of these other factors. Because of that, you will not always see a direct connection between the feedback you have given, and the way a service is run. But with regular feedback from service users, health and care managers will always have a better chance of making good decisions.

Healthwatch is part of a series of checks and balances that ensures that health and care services work properly. A simple overview is as follows:

The Care Quality Commission is the independent regulator of health and social care in England. It monitors, inspects and regulates service providers to make sure they meet fundamental standards of quality and safety. It publishes its findings, including performance ratings to help people choose care.

Monitor protects the interests of patients by making sure that public sector healthcare providers have good leadership and governance. It checks that choice and competition operate in the best interests of patients, and that the NHS payment system rewards quality and efficiency. And it ensures that essential NHS services continue if a provider gets into difficulty.

Bodies like the General Medical Council and Nursing and Midwifery Council set professional standards for doctors, nurses and other health professionals. They support them in achieving the required standards, and take action when they are not met.

NICE – the National Institute for Health and Care Excellence – produces guidance for health and care practitioners (for example on use of medicines), and develops quality standards for providers and commissioners.

The Devon Health and Wellbeing Scrutiny Committee looks into the provision of health services and issues that affect the economic, social or environmental wellbeing of the county, scrutinising how well the Council and its partners are meeting targets.

Healthwatch works particularly closely with the Care Quality Commission and the Scrutiny Committee, ensuring that the experiences of patients and care services users are understood by inspectors and regulators.

Frequently asked questions about health care

If you want to change your GP, visit the GP surgery you want to join and ask them to register you as a patient. You don’t have to tell your current GP that you want to change. However, if you do, it could speed up the process of transferring your medical records. You don’t have to tell the new GP surgery why you want to change, either.
You’ll need to fill in a registration form. A request will then be made to your current GP for your medical records to be transferred to the new GP surgery.

See this page on the NHS Choices website. And this CAB Advice Guide.

If you disagree with the way your GP wants to treat your health problem – or you’re unhappy about the service provided by your GP practice – tell them openly. However, if you feel unable to do so or you’re unhappy with the response you receive, you may wish to make a complaint.

See this NHS Choice page for details on making a complaint.

A GP may be able to remove you from the patient register in some situations, for example, because you move out of the practice area or are physically or verbally abusive to people at the practice. In most cases, the GP must have given you a warning, and provided you with the reasons for your removal from the register.

See this page from NHS Choices and this guide from the CAB.

If you have been violent, or have threatened to be violent, towards your GP or practice staff, and the police have been informed, you can be removed immediately from the GP’s list. You will only be accepted for emergency treatment by the GP who has removed you if the GP is satisfied that it is clinically necessary.

If you have been removed from a GP’s list you may wish to complain if you feel you have been treated unfairly, for example, if you feel discrimination was involved. You may be able to get help to do this from a Citizens Advice Bureau.

You have the right to refuse medical treatment unless you have a notifiable disease or you have been detained for psychiatric reasons (usually called being sectioned). In fact, your consent is needed for most medical matters, but simply going to see a doctor can be regarded as implied consent for an examination or treatment. If you are concerned about a specific type of treatment, the doctor is obliged to describe other forms of treatment that are available. Forcing treatment on a patient who has refused can be considered assault. 

Refusing medical treatment for a child is different. If, as a parent, you have refused treatment for your child, the doctor is obliged to treat the child if it is considered necessary.
You have a right to refuse or stop treatment at any time, even if this means you may die. It is illegal for a doctor to actively cause death, for example massively increasing dosages of drugs which may bring about an earlier death. If you are concerned that you will be unable to make your wishes known at a later stage in an illness, it may be wise to tell the doctor at what stage you want to stop treatment. This is called making an advance decision.

Please see this page from NHS Choices and this page too.

The CAB also has this Advice Guide.

Many people have difficulty in finding a dentist who provides NHS treatment.
If you want NHS dental treatment, you will first need to find out which dentists in your area provide NHS treatment, and then find one who is prepared to accept you for a course of treatment as an NHS patient.
Some dentists do not provide NHS treatment, or only provide treatment to certain groups of people, for example children, or people getting benefits or tax credits.
Not all dentists who provide NHS treatment have to take you on as an NHS patient. If they are unable to take you on, they should tell you that you can go to another dentist.
You don’t have to register with a dentist in order to get NHS treatment, but your dentist may keep a list of regular patients and provide ongoing treatment and care.
Under certain circumstances, your dentist may discontinue a course of treatment. This could happen, for example, if you don’t cooperate with treatment or if you fail to turn up for lots of appointments. Where violence, or the threat of violence occurs, your dentist could discontinue treatment straight away, without any advance warning.
To find a list of dentists who do NHS work in your area phone NHS Direct on: 0845 4647, or look on their website at:

You can also find information on the NHS Choices page here and the Devon Doctors dental service website.

Free treatment is available, but not automatically for every person who enters the UK from abroad. Emergency, compulsory psychiatric, and contagious or infectious disease treatments are free. HIV diagnosis is free but treatment may not be.
As with UK residents, some NHS treatments have to be paid for (such as dentists and opticians), although help is available if you can not afford to pay. People living or working in the UK are entitled to free treatment, but so are people who may be taken ill whilst in the UK for a short stay. Some countries have an arrangement where UK residents can get free medical treatment, and residents of that country can get the same in the UK – this is called a reciprocal agreement.
If you cannot pay for NHS treatment, urgent treatment will still be carried out on the NHS, but you will have to return home for continued treatment. If the need is not urgent, NHS treatment may be offered, but not for free.
Unless you have come to the UK specifically for medical reasons, this entitlement for free treatment extends to GP services, community nurses, midwifery and ambulances, although a GP may require proof of how long you intend to stay in the UK.

Please also see the CAB Advice Guide here.

Frequently asked questions about social care

The Age UK website has a range of guides and fact sheets which can help you choose the right care home. The website also has information about paying for residential care and any help that may be available.
You can view the information online at: you can call the Age UK advice line on 0800 169 6565.
Call the Benefit Enquiry Line on 0800 88 22 00. This is run by the UK Department of Work and Pensions and offers confidential advice and information for people with disabilities, and their carers and representatives, about social security benefits and how to claim them.
You can contact the Pensions Service online or call them on 0800 731 7339. They can work out the amount of State Pension and Pension Credit that you are entitled to. Provide a face to face service in a place that is convenient for you or in the comfort of your own home if your business cannot be dealt with over the telephone. Inform you of your entitlements and answer questions over the phone and by post and by email. Tell you how you can access other pension-related entitlements and services

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